Name | Name
|
Date of Birth
| Date Of Birth
|
Street Address
| Street Address
|
City
| City
|
Postal Code
| Postal Code
|
Year Built
| Year Built
|
Storey | 1 Yes 2 2 3 3
|
Units | Units
|
Total Square Footage (Excluding Basement)
| SqFtg
|
Exterior | Exterior
|
Roof Age?
| Age
|
Type of Roof?
| Type Of Roof
|
Heating
| Oil Oil Wood Wood Electric Electric
|
if any have been updated, If so when? | When was it updated?
|
Plumbing | Copper Copper Plastic Plastic
|
Electrical Amps
| ElectricAmp
|
Bath | Number Of Baths
|
Garage | Yes No
|
Attached or Detached? | Attached AttachedGarage Detached Detached Garage |
Porch or Deck
| Yes No
|
If so, Square Footage?
| Square Footage
|
How Many Mortgages?
| # Of Mortgages
|
Any Payment Issues?
| Yes No
|
Any Claim Issues?
| Yes No
|
Alarm System
| Yes No
|
Current Carrier?
| Current Carrier
|
Expiry of Current Carrier?
| Expiry Of Current Carrier
|
Consecutive Years Insured?
| Years Insured
|
Phone Number? | PhoneNumber
|
| |